ANDRE MAURICE FABIEN MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036122722

License Status

NOT RENEWED

Business

First Name

ANDRE

Middle

MAURICE

Last Name

FABIEN

Suffix

Business Name

ANDRE MAURICE FABIEN MD

Original Issue Date

02/27/2009

Effective Date

04/28/2011

Expiration Date

07/31/2014

City

CHICAGO

State

Zip

60611

County

COOK

Ever Disciplined

LastModifiedDate

11/17/2014